MSRA: Bowel Problems Flashcards
What are the features of Hirschsprung’s disease?
Delayed passage of meconium and abdominal distention
May develop overflow diarrhoea
May present with life-threatening enterocolitis due to c.dif
What are the features of necrotising enterocolitis?
Preterm infant
Within first few weeks of life
Poor feeding, abdominal distension, bloody stools, bile stained vomit
What are the features of pyloric stenosis?
Boy, presents between 2 and 6 weeks of life
Projectile bilious vomiting, weight loss, poor feeding
VBG hypochloraemic, hypokalaemic metabolic alkalosis
What are the features of GORD?
Typically develops before 8 weeks
Vomiting/regurgitation following feeds
What is the management of GORD?
Thickened feeds ONLY IF BOTTLE FED
After D+L -> trial of Gaviscon
After Gaviscon -> consider PPI
What is the management of IgE-mediated CMPA?
Management in secondary care
What is the first step of the milk ladder?
Malted milk biscuits
What is the first step of the egg ladder?
Eggs baked in cake
What is the laxative of choice for constipation in children?
Macrogol laxative e.g. Movicol
What is the management of non-IgE cow’s milk protein allergy?
- Extensive hydrolysed formula
- Amino acid based formula
Milk free diet for at least 6 months before re-introduction using the milk ladder
What are the features of intussusception?
severe colickly abdominal pain
Vomitting, constipation
Sausage shaped abodminal mass
Redcurrant jelly stools
What is the investigation of choice in intussusception?
Ultrasound scan
What are the features of Meckel’s diverticulum?
Abdominal pain mimicking appendicitis
Rectal bleeding
Intestinal obstruction due to omphalomesenteric band
What is the management of threadworms? (Enterobius vermicularis)
Prescribe a single dose of Mebendazole for the household and give hygiene advice
